Pancho - PER-LUI-88

Code: PER-LUI-88
Mercy ID: V-01116-21
Encounter Date: 03/12/2003
Last: Pereyra
First: Luis
DOB: 12/13/1988
County: Cobb
Street: 2813 Belaire Circle
City: Doraville
State: GA

Zip

30340-

Home

(678) 626-0626

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Janett Mantilla	02/01/1966	Nicaragua
Father	Jose luis Pereyra	12/13/1966	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Sequoyah
Grade: 8th.
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: Y. Garcia
Data Entry: K. Aleman